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Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
INTRODUCTION: Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. OBJECTIVES: To perfo...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476038/ https://www.ncbi.nlm.nih.gov/pubmed/34570805 http://dx.doi.org/10.1371/journal.pone.0257565 |
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author | Cheng, Hui Mei Zhao, Xiahong Lim, Wei Shyann Tan, Beatrice Jia Min Tey, Hong Liang |
author_facet | Cheng, Hui Mei Zhao, Xiahong Lim, Wei Shyann Tan, Beatrice Jia Min Tey, Hong Liang |
author_sort | Cheng, Hui Mei |
collection | PubMed |
description | INTRODUCTION: Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. OBJECTIVES: To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. METHODS: In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). RESULTS: Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). CONCLUSIONS: In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result. |
format | Online Article Text |
id | pubmed-8476038 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-84760382021-09-28 Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility Cheng, Hui Mei Zhao, Xiahong Lim, Wei Shyann Tan, Beatrice Jia Min Tey, Hong Liang PLoS One Research Article INTRODUCTION: Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. OBJECTIVES: To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. METHODS: In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). RESULTS: Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). CONCLUSIONS: In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result. Public Library of Science 2021-09-27 /pmc/articles/PMC8476038/ /pubmed/34570805 http://dx.doi.org/10.1371/journal.pone.0257565 Text en © 2021 Cheng et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Cheng, Hui Mei Zhao, Xiahong Lim, Wei Shyann Tan, Beatrice Jia Min Tey, Hong Liang Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
title | Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
title_full | Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
title_fullStr | Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
title_full_unstemmed | Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
title_short | Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
title_sort | factors affecting duration of sars-cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476038/ https://www.ncbi.nlm.nih.gov/pubmed/34570805 http://dx.doi.org/10.1371/journal.pone.0257565 |
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